Our Insurance and Billing Policy
Aspira Labs® accepts all insurance. We work closely with patients with various programs including our Price Transparency Program.
Billing Policy Overview
Aspira Labs recognizes that some patients will need assistance in order to access testing and we will work with patients with financial constraints to create access to testing, as may be permitted by applicable law or Aspira Labs policy.
- We will seek positive coverage decisions with all insurance providers, including Medicare, to provide appropriate coverage for patients.
- If a claim is denied, we will, to the extent permitted, appeal to the patient’s insurance carrier on behalf of the patient to assist in claims reimbursement.
- We offer a financial assistance program to eligible patients in accordance with applicable laws.
- Only after exhausting all other options will we seek fair reimbursement from the patient as required.
Insurance Claim Requirements
Billing Patient’s Health Insurance – Laboratory tests are offered nationally and may be covered by the patient’s insurance. All patients are encouraged to contact their insurance carrier to understand and confirm their specific insurance coverage prior to testing. In order for Aspira Labs to file a claim directly with a patient’s health insurance plan we require the following:
- A completed test requisition form with diagnosis codes and patient history information supporting the medical necessity of testing and authorizing Aspira Labs to bill the patient’s health insurance plan.
- An enlarged copy of the patient’s health insurance plan card (front and back) with each test requisition is preferred.
- When required by the patient’s health insurance plan, a prior authorization approval number.
Insurance Coverage and Patient Payments
Contracted Insurance – There are hundreds of insurance plans in the United States, some of which may be contracted with Aspira Labs. Aspira Labs bills all insurances. If the patient’s health insurance plan is contracted with Aspira Labs, it will usually pay for most, and possibly all, of the charges for services provided to the patient. Aspira Labs will bill the patient for any deductible, coinsurance, or required amount after receipt of the explanation of benefits (EOB).
Non contracted health insurance carriers may still cover all or some portion of the bill for the provided testing services. Patient financial responsibility for any applicable deductible, co-insurance and copayments will still apply.
Denied Claims and Appeals
A patient’s health insurance carrier can deny payment for treatment or medical services for many reasons. If the claim is denied, Aspira Labs will appeal the claim to the insurance company as permitted. Additionally, Aspira Labs can offer tools and resources to help patients throughout the appeal process. We offer financial assistance when insurance denies payment. Please see the payment assistance program section below.
Payment Assistance Programs for Patients with No Insurance Coverage
Programs are available for patients who are not covered by any health insurance. Aspira Labs will work with the patient to determine their eligibility for each program. Uninsured and underinsured patients who meet specific financial criteria may be eligible for the Aspira Labs Financial Assistance Program.
Please call our customer service department at 866.927.7472 to arrange a payment plan for up to 6 monthly installments.
Financial Assistance Program
Patients who are uninsured may be eligible for financial assistance under the Aspira Labs Financial Assistance Program (FAP). The patient must complete the FAP Application or contact the Aspira Labs billing department to determine eligibility for the FAP. The patient will be required to submit proof of eligibility for these programs to verify income and number of dependents. In certain circumstances, Financial Assistance Programs may be combined with other Payment Assistance Program.
The following information serves as a preliminary guide to help determine if the patient qualifies for FAP, but please see the FAP application for specific documentation requirements:
- The patient must be a US resident or citizen.
- If the patient is eligible for federal food stamps, qualifies for State Medical Assistance, or is eligible for the Hill-Burton Program, they automatically qualify.
- In the event that the patient does not automatically qualify due to the participation in one of the above-listed programs, the patient will need to submit proof of gross income for the patient and spouse (eg, W-2) as well as the number of dependents.
Aspira Labs is committed to working with patients to help determine if they qualify for financial assistance. Once we receive a request for financial assistance and review income, we will promptly notify the patient and will discuss costs. If the patient qualifies for assistance but has already received a bill, we will indicate the portion of the bill that will be deducted due to the application of the FAP credit.